Provider Demographics
NPI:1528285186
Name:NOYES, LINNEA SMITH (PHD)
Entity type:Individual
Prefix:DR
First Name:LINNEA
Middle Name:SMITH
Last Name:NOYES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:204 CANYON RD
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84103-2554
Mailing Address - Country:US
Mailing Address - Phone:801-531-7464
Mailing Address - Fax:801-532-3387
Practice Address - Street 1:204 CANYON RD
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84103-2554
Practice Address - Country:US
Practice Address - Phone:801-531-7464
Practice Address - Fax:801-532-3387
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4770249-2501103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT14770249202001OtherREGENCE BCBS
UT14770249202001OtherREGENCE VALUECARE
UT14770249202001OtherREGENCE BCBS